Commonwealth Medicine - complex medical needshttps://commed.umassmed.edu/news-tags/complex-medical-needs
enUMass Medical School pharmacists, clinical services staff support medically complex individuals through Community Case Management collaborationhttps://commed.umassmed.edu/news/2016/09/01/umass-medical-school-pharmacists-clinical-services-staff-support-medically-complex
<div class="field field-name-field-news-date field-type-datetime field-label-hidden"><div class="field-items"><div class="field-item even"><span class="date-display-single" property="dc:date" datatype="xsd:dateTime" content="2016-09-01T08:30:00-04:00">September 01, 2016</span></div></div></div><div class="field field-name-field-by-line field-type-taxonomy-term-reference field-label-inline inline"><div class="field-label">By:&nbsp;</div><div class="field-items"><div class="field-item even"><a href="/line/ellen-moran">Ellen Moran</a></div></div></div><div class="field field-name-field-news-featured-image field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><img class="adaptive-image" typeof="foaf:Image" src="https://commed.umassmed.edu/sites/default/files/styles/featured_news/adaptive-image/public/images/news/pharmacist_altered_0.jpg?itok=6lXDjKSe" alt="Pharmacist" /></div></div></div><div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even" property="content:encoded"><p>A Massachusetts family is saving nearly $500 a year on a medication for an ill child, thanks to the collaboration between UMass Medical School’s clinical pharmacists and its Community Case Management Program.</p>
<p>The family had been paying monthly copays for an appetite stimulant prescribed to the child. Clinical Pharmacy Services, a unit within UMass Medical School's Commonwealth Medicine division, conducted a medication review and discovered the copay could be covered by the state Medicaid program, MassHealth. </p>
<p>“The pharmacy had billed the medication to the primary insurance but the family had been paying $40 per month for the copay,” said Nicole Trask, PharmD, consultant pharmacist for Clinical Pharmacy Services. “We helped the pharmacy appropriately bill the copay from the primary insurance to MassHealth, which resulted in an annual cost savings of $480 for the family.”</p>
<p>The Community Case Management Program, a partnership between MassHealth and Commonwealth Medicine, coordinates community long-term services and supports (LTSS) for 838 MassHealth members with complex medical needs and their caregivers. Pharmacists in Clinical Pharmacy Services provide operational and clinical services to CCM to ensure those members have access to pharmacy services.</p>
<p>The work being done by CCM and Clinical Pharmacy Services enables individuals with complex chronic health problems to live at home instead of in an institution and makes sure the services they receive are medically necessary, which saves money for MassHealth.</p>
<p>CCM was established in 2003 to coordinate community services for medically complex children and young adults age 22 or younger. In 2013, MassHealth expanded CCM to members of all ages who qualify. Clinical Pharmacy Services has been consulting with CCM since 2006.</p>
<p> “We’re authorizing services that are medically necessary for complex populations living in the community, while making sure we avoid duplicating services,” said Kerri Ikenberry, RN, BSN, director of clinical services in Disability &amp; Community Services, a unit within Commonwealth Medicine.</p>
<p>Another example of the collaboration helping patients involves a MassHealth member who was in line at a local pharmacy. When she was told her prescription would be denied by MassHealth, she contacted CCM from her place in line and CCM asked Clinical Pharmacy Services to review the medication. The Clinical Pharmacy Services pharmacist called the pharmacy where the woman was waiting and assisted them with billing the prescription, which was then filled the same day.</p>
<p> “We’re making sure MassHealth members don’t go without the medications they need,” Trask said.</p>
<p>CCM assesses MassHealth members with complex medical needs to determine whether they qualify for in-home continuous skilled nursing care, and authorizes and coordinates the services. In addition to nursing care, services may include a personal care attendant, oxygen and respiratory equipment, medical supplies and therapy services. The CCM team includes nurse clinical managers, physical therapists, occupational therapists, respiratory therapists and social workers. CCM nurse clinical managers reach out to CPS pharmacists for assistance with billing issues at the pharmacy, assistance with the medication prior authorization process, and medication reviews to provide insight into members’ needs. </p>
<p>Clinical Pharmacy Services does about 30 consults a month for CCM, with a high of 45 in January, Trask said.</p>
<p>“Clinical Pharmacy Services pharmacists and pharmacy residents are the patient’s advocate in obtaining medications through the MassHealth program,” said Bonnie Greenwood, PharmD, BCPS, director of clinical programs for Clinical Pharmacy Services.</p>
<p>CCM’s outreach to MassHealth members with complex medical needs has made a difference by helping vulnerable populations.</p>
<p>“CCM acts as a single entry point for members to MassHealth,” Ikenberry said. “Providing service coordination for this medically fragile population has been well-received by both MassHealth members and providers of long-term services and supports.”</p>
<p>The work Clinical Pharmacy Services does with CCM also provides an effective educational tool for the program’s pharmacy residents.</p>
<p>“This is an example of how we’re teaching the next generation of pharmacists to work with patients,” Greenwood said.</p>
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<a href="/news/2013/10/02/community-case-management-celebrates-10-years-service-massachusetts-families">Community Case Management celebrates 10 years of service to Massachusetts families</a> </p>
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Wed, 31 Aug 2016 21:05:49 +0000ellen5406 at https://commed.umassmed.eduhttps://commed.umassmed.edu/news/2016/09/01/umass-medical-school-pharmacists-clinical-services-staff-support-medically-complex#commentsCommunity Case Management celebrates 10 years of service to Massachusetts familieshttps://commed.umassmed.edu/news/2013/10/02/community-case-management-celebrates-10-years-service-massachusetts-families
<div class="field field-name-field-news-date field-type-datetime field-label-hidden"><div class="field-items"><div class="field-item even"><span class="date-display-single" property="dc:date" datatype="xsd:dateTime" content="2013-10-02T15:00:00-04:00">October 02, 2013</span></div></div></div><div class="field field-name-field-news-featured-image field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><img class="adaptive-image" typeof="foaf:Image" src="https://commed.umassmed.edu/sites/default/files/styles/featured_news/adaptive-image/public/images/news/CCM%20group%20shot_0.JPG?itok=ierr1IU1" alt="Community Case Management celebrates 10 years of service to Massachusetts families" /></div></div></div><div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even" property="content:encoded"><p>Without Community Case Management (CCM), a service of UMass Medical School’s Commonwealth Medicine division, more than a thousand children and young adults in Massachusetts with complex medical needs may have been forced to leave their families and live in institutions to get the care they need.</p>
<p>The service’s important work both managing the needs of its members and keeping families intact was honored at a 10<sup>th</sup> anniversary celebration hosted by Commonwealth Medicine on Tuesday, Oct. 1.</p>
<p>“What an impact this program has had, and continues to have, in helping one of the most vulnerable populations in Massachusetts,” said <a href="http://commed.umassmed.edu/about-us/leadership-team/patti-onorato">Patti Onorato</a>, RN, MS, APN, deputy chief operating officer of Commonwealth Medicine. “Your outreach, how important it is to the families… They feel so supported by you.”</p>
<p>The Community Case Management Program, a partnership between Commonwealth Medicine and MassHealth, supports individuals with complex medical needs. The program aims to help MassHealth members manage the challenge of coordinating multiple care providers, services, and necessary supplies for chronic health problems.</p>
<p>“I couldn’t be more pleased with the work that you do, and your leadership,” said Kenneth J. Smith, director of MassHealth Long Term Services and Supports. Smith knows the work of CCM well from his days as assistant commissioner of the state Department of Developmental Services, where he worked on behalf of individuals, some of whom benefited greatly from community services coordinated through CCM.</p>
<p>CCM should be proud of its work, in part because of the high member satisfaction, said<strong> </strong><a href="http://commed.umassmed.edu/dcs/our-team/karen-williams">Karen Williams</a>, MSW, who helps lead the program as senior director of Disability and Community Services. In a recent survey, 90 percent of members indicated they were very satisfied with CCM’s service.<strong> </strong>“It’s been wonderfully successful,” Williams said of the program.</p>
<p>Numbers show the true impact of the CCM service, said <a href="http://commed.umassmed.edu/dcs/our-team/jessica-carpenter">Jessica Carpenter</a>, MS, RD, LDN, director of Disability and Community Services, and former CCM director. Since the program began in 2003, CCM has coordinated services for more than 1,600 members, said Carpenter. The program currently serves 655 Massachusetts residents.</p>
<p>During the anniversary celebration, Onorato shared feedback from a CCM family that described the service as a helpful advocate for coordinating services. The family said that their son would be in a nursing home without it and probably would not have survived. “We have had so many difficult medical and equipment issues this year and have found the support of CCM to be lifesaving for our son and for our family,” Onorato said, reading the family’s comments aloud.</p>
<p>Onorato also took the opportunity to thank the various Commonwealth Medicine units that support CCM, including the Center for Health Care Financing, the Center for Health Policy and Research, the Office of Clinical Affairs, Disability Evaluation Services and Clinical Pharmacy Services.</p>
</div></div></div>Thu, 31 Mar 2016 18:56:36 +0000Jen2341 at https://commed.umassmed.eduhttps://commed.umassmed.edu/news/2013/10/02/community-case-management-celebrates-10-years-service-massachusetts-families#commentsCase Management conference to feature presentation on UMass Medical School Community Case Management servicehttps://commed.umassmed.edu/news/2014/10/02/case-management-conference-feature-presentation-umass-medical-school-community-case-
<div class="field field-name-field-news-date field-type-datetime field-label-hidden"><div class="field-items"><div class="field-item even"><span class="date-display-single" property="dc:date" datatype="xsd:dateTime" content="2014-10-02T14:45:00-04:00">October 02, 2014</span></div></div></div><div class="field field-name-field-news-featured-image field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><img class="adaptive-image" typeof="foaf:Image" src="https://commed.umassmed.edu/sites/default/files/styles/featured_news/adaptive-image/public/images/news/Sister-sitting-next-to-disabled-brother-in-wheelchair-at-playground-000053086658_Large_0.jpg?itok=Pg8yelFq" alt="Case Management conference to feature presentation on UMass Medical School Community Case Management service" /></div></div></div><div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even" property="content:encoded"><p>How Community Case Management (CCM), a partnership between MassHealth and UMass Medical School’s Commonwealth Medicine division, supports medically complex individuals so they can live safely in the community will be highlighted during a presentation at the Case Management Society of New England’s <a href="http://www.cmsne.org/events/annualconference.php">25th Annual Conference</a> at the Holiday Inn Boxborough on Friday, Oct. 3.</p>
<p>“Long Term Services and Supports Management of the Medically Fragile Population” will be presented jointly by staff from Disability &amp; Community Services, Kerri Ikenberry, RN, BSN, director of clinical services; and Susan Brown, MS, OTR/L, associate director of allied health services. The presentation will explain the CCM service, highlight successes and best practices, as well as share lessons learned.</p>
<p>CCM, which celebrated its 10<sup>th</sup> anniversary last fall, supports individuals in Massachusetts with complex medical needs. The program aims to help MassHealth members manage the challenge of coordinating multiple care providers, services, and necessary supplies for chronic health problems. Surveys have shown high member satisfaction with the service.</p>
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<a href="/news/2013/10/02/community-case-management-celebrates-10-years-service-massachusetts-families">Community Case Management celebrates 10 years of service to Massachusetts families</a> </p>
Thu, 31 Mar 2016 18:47:57 +0000Jen2331 at https://commed.umassmed.eduhttps://commed.umassmed.edu/news/2014/10/02/case-management-conference-feature-presentation-umass-medical-school-community-case-#commentsBoston Globe: Community Case Management program provides caregivers for families of medically complex childrenhttps://commed.umassmed.edu/news/2014/02/10/boston-globe-profiles-family-supported-community-case-management-umms-program-provid
<div class="field field-name-field-news-date field-type-datetime field-label-hidden"><div class="field-items"><div class="field-item even"><span class="date-display-single" property="dc:date" datatype="xsd:dateTime" content="2014-02-10T14:30:00-05:00">February 10, 2014</span></div></div></div><div class="field field-name-field-news-video field-type-video-embed-field field-label-hidden"><div class="field-items"><div class="field-item even">
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<p>Community Case Management, a service created by UMass Medical School to help keep medically complex children with their families instead of in pediatric nursing homes, is assisting nearly 700 children and adults, according to an article in the <a href="http://www.bostonglobe.com/metro/regionals/south/2014/02/09/special-needs-dedham-boy-shows-power-parental-love/MZQ27x5FsyXo4Olhm8HUiP/story.html"><em>Sunday Boston Globe</em></a>.</p>
<p>“Whatever these kids need, they will get: physical therapy, occupational therapy, dieticians, specialized wheelchairs, feeding tubes,” Joyce Murphy, MPA, Commonwealth Medicine executive vice chancellor, told the Globe for the Feb. 9 story. “Without the service, these kids would be forced to live in institutions.”</p>
<p>The article features 9-year-old John Wilmar, who has Toriello-Carey syndrome and recently learned to walk down stairs, feed himself and drink from a cup. April and Shawn Wilmar, his parents, credit Community Case Management for significantly helping John develop.</p>
<p>“It’s really nice to have the added support,” April Wilmar said. “It’s really helped him progress.”</p>
<p>Community Case Management is supported by a partnership between UMass Medical School’s Commonwealth Medicine division and the state Executive Office of Health and Human Services. It provides a single point of entry for all members’ long-term care needs, including continuous skilled nursing, personal care attendant services, and durable medical equipment and therapy services.</p>
<p>Community Case Management has made it possible for parents, like John’s, to focus on family while a nurse case manager handles the challenge of coordinating multiple care providers, services, and necessary supplies for chronic health problems.</p>
<p>Since it began in 2003, the service has assisted more than 1,600 members.</p>
<p>Children and adults qualify for the service if they need more than two continuous hours of skilled nursing services. All Community Case Management families are also members of MassHealth, the Massachusetts Medicaid program.</p>
<p>Community Case Management nurses also work with staff at neonatal intensive care units, pediatric intensive care units, acute care facilities and rehabilitation facilities across the state – including UMass Memorial Medical Center in Worcester, Children’s Hospital Boston, Baystate Medical Center in Springfield, and Spaulding Rehabilitation Hospital in Boston – to support discharge plan needs for members who qualify for the service.</p>
</div></div></div><div class="field field-name-field-news-photo-gallery field-type-image field-label-abovec"><div class="field-label">Photo Gallery&nbsp;</div><div class="field-items"><div class="field-item even"><a href="https://commed.umassmed.edu/sites/default/files/styles/photo_gallery_zoom/public/images/news/John%20baseball_0.JPG?itok=s-fZ6jzR" title="Community Case Management member John Wilmar, who has Toriello-Carey syndrome." class="colorbox" data-colorbox-gallery="gallery-all-z47yLlxhv3Y" data-cbox-img-attrs="{&quot;title&quot;: &quot;&quot;, &quot;alt&quot;: &quot;Community Case Management member John Wilmar, who has Toriello-Carey syndrome.&quot;}"><img class="adaptive-image" typeof="foaf:Image" src="https://commed.umassmed.edu/sites/default/files/styles/news_photo_gallery/adaptive-image/public/images/news/John%20baseball_0.JPG?itok=0YqeozHd" alt="Community Case Management member John Wilmar, who has Toriello-Carey syndrome." title="" /></a></div><div class="field-item odd"><a href="https://commed.umassmed.edu/sites/default/files/styles/photo_gallery_zoom/public/images/news/Boys1.JPG?itok=cj8U6fjl" title="Community Case Management member John Wilmar and his brotehr Ryan. " class="colorbox" data-colorbox-gallery="gallery-all-z47yLlxhv3Y" data-cbox-img-attrs="{&quot;title&quot;: &quot;&quot;, &quot;alt&quot;: &quot;Community Case Management member John Wilmar and his brotehr Ryan. &quot;}"><img class="adaptive-image" typeof="foaf:Image" src="https://commed.umassmed.edu/sites/default/files/styles/news_photo_gallery/adaptive-image/public/images/news/Boys1.JPG?itok=nPEegYZY" alt="Community Case Management member John Wilmar and his brotehr Ryan. " title="" /></a></div><div class="field-item even"><a href="https://commed.umassmed.edu/sites/default/files/styles/photo_gallery_zoom/public/images/news/CCM2.jpg?itok=IApxFw_D" title="The Wilmar family, users of the Community Case Management service. " class="colorbox" data-colorbox-gallery="gallery-all-z47yLlxhv3Y" data-cbox-img-attrs="{&quot;title&quot;: &quot;&quot;, &quot;alt&quot;: &quot;The Wilmar family, users of the Community Case Management service. &quot;}"><img class="adaptive-image" typeof="foaf:Image" src="https://commed.umassmed.edu/sites/default/files/styles/news_photo_gallery/adaptive-image/public/images/news/CCM2.jpg?itok=OEq59yFj" alt="The Wilmar family, users of the Community Case Management service. " title="" /></a></div></div></div> <h3 class="field-label">
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